1. The second possible tumor is in the pineal area. They do not believe that it is tumor, although they will continue to track it and have me do Dopa PET scans at a regular 6 month intervals to monitor the situation. They have seen a similar situation in several other tumor patients and they wonder if it's due to excess stress, or irregular sleep patters. The pineal gland regulates circadian rhythms. Does not look like a second brain tumor!!!
2. After reviewing the fMRI with Liau, it is clear that my speech area is not near the tumor. The tumor, instead has grown into my motor skills, and sensory area. Fortunately, you do not need to be awake for the testing of the motor skill or sensory area. During a regular brain surgery, they can poke certain nerves, or stimulate different brain tissue to check and see if they're dealing with brain tissue or tumor tissue. They can do all the testing they need while I'm fast asleep. No need for a partially awake surgery - just a regular one!!!
3. The regular MRI shows that my tumor is still not taking up the gadolinium dye (which would signify that Herman had progressed to a stage III or IIII), which would mean that I'm still at stage II. This is just a preliminary prognosis, they will know for sure when they get the pathology back after the brain surgery. Sometimes a stage III isn't taking up the dye, even though it has progressed - so no guarantee, but it's a good sign. Looking good for a stable stage II infiltrating astrocytoma!!!
4. I will be the first brain surgery of the day, this Thursday the 18th of October. The procedure should take about 4.5 hours. If all goes well, I should be released from Ronald Regan Hospital sometime Sunday.
5. After I'm released from the hospital I will come back for a suture (staples) removal. Then an appointment to get the pathology of the tumor. Unless there is some unforeseen event, I should be flying home on November 2nd in the evening.
6. Dr Liau believes that this surgery will improve my quality of life. She believes that removing the tumor will allow my body to continue to gain back the language skills that were damaged after the first surgery. They reviewed the results from the cognitive testing from last Friday and they do see deficits, but they believe that with time after this surgery I will continue to improve.
7. If there are complications from this surgery they are anticipating that they would include the inability to feel things on the right side of my body, or difficulty with moving the right side of my body. If that is the case, Dr Liau believes that with dedicated physical therapy I will be able to completely regain any lack of sensation or mobility. She feels confident and (in my opinion) excited for the tumor resection, believing fully that this is going to be a huge improvement in my life and in my future. She is the most humble doctor I've ever met, with a healthy amount excitement and immense curiosity. I wish you all could have been in the appointment. I have complete confidence in her. In fact, I wish we could hang out, I'd love to be friends and hear all about her research and views on life. The woman is interesting in so many ways.
8. If all goes well, I will fly back down 3-4 weeks after the surgery for them to harvest my white blood cells. I will then fly home and come back down to UCLA one week later for my first shot. There is a chance that there will not be enough tumor tissue to give me a personalized vaccine. There are a few other factors where they have to analyze the tumor proteins to make sure that it will work for the vaccine. There are a lot of factors that we will not know about until they have the tissue in their hands and can run a battery of tests. Fingers crossed that I'll be able to get the vaccine. If not, at least they will have the tumor tissue out of my brain. Adios Hermie!!
Here's a photo of mom, dad, and I after the appointment. Mom wanted to celebrate the great news with a group photo :)
Here's another photo that my mom took as they were about to send me into the fMRI machine yesterday. That was a crazy experience. I was absolutely exhausted after that. Completely spent. I'll tell about it another time.
